Individual
JOHN W HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
626 PARK ST, HONESDALE, PA 18431
(570) 253-1720
(570) 253-0841
Mailing address
200 MIFFLIN AVE, SCRANTON, PA 18503
(570) 342-3145
(570) 344-1309
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001118
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000548502
—
PA
01
—
15486
GELSINGER HEALTH PLAN
—
01
—
410024728
RAILROAD MEDICARE
—
01
—
506554
AETNA
—
01
—
HU289290
HIGH MARK BLUE SHIELD
—
Enumeration date
08/13/2006
Last updated
01/08/2010
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